The Centers for Medicare & Medicaid Services (CMS) has formally required more than 3,000 U.S. acute care hospitals to report a standardized malnutrition quality measure beginning in 2028 — a milestone that nutrition and dietetics professionals have worked toward for more than a decade.
What CMS Decided
The new requirement is embedded in the fiscal year 2027 Inpatient Prospective Payment System (IPPS) final rule, announced August 4, 2026. Under the rule, all hospitals participating in CMS’s Hospital Inpatient Quality Reporting (IQR) Program must track and report the Malnutrition Care Score (MCS) — making it the first nutrition-focused electronic clinical quality measure ever required under the IQR Program. According to the Academy of Nutrition and Dietetics via GlobeNewswire, CMS first adopted the measure on a voluntary basis in 2024, but mandatory reporting begins with the 2028 payment year.
What the Score Actually Measures
The MCS evaluates whether each hospitalized adult (18 years and older, staying at least 24 hours) receives four evidence-based steps: malnutrition risk screening at admission, a full nutrition assessment for patients flagged as at risk, a formal malnutrition diagnosis where warranted, and a written nutrition care plan for those diagnosed. Registered dietitian nutritionists play a central role in all four stages — identifying at-risk patients, conducting assessments, and designing individualized care plans. The Academy developed the measure starting in 2013, refining it in collaboration with healthcare organizations, clinicians, and patients over more than a decade.
Why It Matters
Malnutrition in hospital settings is both common and costly: it prolongs recovery, raises the risk of complications, and drives up readmission rates. Requiring hospitals to document all four MCS steps systematically — rather than addressing nutrition on an ad hoc basis — is expected to make malnutrition screening as routine as vital signs. For patients, that means a greater chance that a deficiency is caught and corrected before it compounds other conditions. For dietitians and nutrition teams, the rule creates a formal accountability structure that elevates their clinical role in inpatient care across the country.